{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Mary E Casceillo","gend":1,"currentgend":"","add":"140 AIRPORT DR","city":"YORK","state":"ME","zip":"03909","dob":"1956-02-26","age":"","mstatus":"","insh":"10000085792","cliId":"","pno":2035564578,"cno":"","email":"mimicas56@gmail.com","ename":"","eno":"","pphy":"ROBINSON, ELISABETH S","ppno":6034316677,"pcpadd":"Whole Life Health Care,100 Shattuck Way Suite 100","pcpcity":"Newington","pcpstate":"NH","pcpzip":"03801","pcpcounty":"","pcpid":"","pcpname":"WHOLE LIFE HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"140 AIRPORT DR","madd2":"","madd3":"","mcity":"YORK","mstate":"ME","mzip":"03909","pcpfaxno":6036102232,"pcpnpi":1255421194,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2AE4AC3TU67","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R5383","M9903","M9905","M5450","M9902","S52532D","Z4789","S52592A","R42","M359","L570","M546","I5181","E785","S52552A","M25539","Z1231","R92343","S52502A","G8918","R0609","B349","S52532A","Z0000","L821","D229","L578","D485","D1801","Z08","R300","J301","J3081","H1013","G4730","M810","L2389","L820","Z79899","J209","R6889","Z85828","M9901","M542","Z0100","M85852","R059","N958","H40013","I700","N3000","S39012A","R921","N6321","M797","M2550","M25532","R413","H35342","H5213","M47816","E871","S52292A","N898","R922","R296","M1990","D2362","H52222"],"date":["2024-02-07","2025-10-29","2025-09-24","2025-10-29","2025-10-29","2025-03-17","2025-03-17","2024-12-17","2023-06-05","2025-11-13","2025-10-14","2025-10-29","2025-05-19","2025-09-23","2024-12-06","2024-08-07","2025-03-28","2024-03-18","2024-12-17","2024-12-17","2024-03-14","2025-09-08","2024-12-23","2025-06-02","2025-08-12","2025-08-12","2025-08-12","2024-02-08","2024-02-08","2024-02-08","2023-07-21","2023-07-21","2023-07-21","2023-07-21","2024-08-21","2024-09-05","2025-01-07","2024-04-18","2024-06-24","2025-09-15","2024-02-03","2023-02-14","2024-12-04","2024-12-04","2025-06-30","2024-08-20","2025-09-15","2024-08-20","2025-06-30","2023-10-06","2024-09-16","2024-07-08","2024-03-18","2024-03-18","2025-05-23","2023-06-23","2024-12-05","2022-12-22","2025-06-30","2024-06-24","2024-07-08","2023-01-04","2024-12-17","2023-02-08","2023-03-13","2024-12-05","2022-09-14","2022-06-16","2022-06-15"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","EZETIMIBE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","HYDROXYCHLOROQUINE SULFATE","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","MOMETASONE FUROATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Assessment of Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}